Public Health Law Map - Beta 5 - Medical and Public Health Law Site

If the medical office is destroyed, the first step is to contact all of the patients: (1) to
remind patients in need of continuing care that they must contact the new office for
an appointment; and (2) to reassure patients that the physician will reopen the
office and that they need not seek medical care elsewhere. Contacting the patients
will be much easier if the medical office maintains a patient list in a secure place
away from the office in which the records are kept. This list should contain enough
information to locate patients and, ideally, to reconstruct a skeleton of the patient’s
medical history. Keeping such a list is time consuming, but it can be an effective
marketing tool. A physician can use routine mailings to established patients to build
loyalty. Mailings directed at patients with chronic conditions can be used to remind
them to come in for follow-up care. This is good business and good medical
management.
d) Retention of Records
There are few statutory requirements on how long a medical office must retain
private office records. From a risk management point of view, it is desirable for all
records to be retained indefinitely in the office. Unfortunately, this may be
economically unfeasible and interfere with access to active records. All medical
offices should have a formal records retention policy that balances convenient and
economic storage with easy access to active records.
Records for any patient seen in the last two years must be considered active unless
the patient has died. If the patient has not been seen for two years and does not
have a continuing medical condition, the medical care practitioner may consider
putting the patient’s records into less accessible storage while retaining the cover
sheet of the chart in case the patient is seen again. The cover sheet will facilitate
urgent care in either the office or the emergency room before the full record can be
retrieved.
The medical care practitioner must maintain a separate tracking system for all
patients with implants of any kind. Although this has always been done for heart
valves and pacemakers, it is important for other implants that either need replacing
or are subject to FDA (Food and Drug Administration) recalls or reviews. This
includes intrauterine devices and implantable contraceptives, including Depo-
Provera. The tracking system should identify each patient with an implant, the type
of implant, the last patient visit, and any necessary review dates. For implantable
contraceptives, such as Norplant, the patient should be seen each year and should
be notified in the fourth year that the contraceptive effect is wearing off. For Depo-
Provera, the patient must be followed up every three months, or whatever is the
effective length of the preparation that is used.
The physician should contact patients with chronic medical problems who have not
been seen recently. If the patient is being treated by a new physician, that
physician’s name should be noted in the chart. If the patient cannot be found and is
not in need of specific follow-up care, the physician should send a postcard to the
patient’s last known address. If the card is returned as undeliverable, it should be
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